re: Ignorant question about health insurance deductibles and out of pocket maximums

I don[t know about the specifics of your plan, but the way the high deductible plans are working that most companies are adopting is by calendar year.

On our plan, we have a total family $3,000 deductible. The individual plan deductible is $1500. When we go to the doctor, we are to be charged the price for that service that the insurance company would ordinarily receive. This includes prescriptions. Paid $179 the other day for a script and that was with the insurance discount.

When we reach $3000 out of pocket in a calendar year, we are responsible for 20% of the charges until we have spent out of pocket $10 grand. We have a HSA that we are socking money into and we have been paying the out of pocket medical expenses with the pre tax HSA.

From what you posted, sounds like you have to pay $500 out of pocket, then likely some type of split until you reach $3000. Read your information carefully because in some instances a service is covered 100% and not subject to deductible. For instance, one check up a year etc. Policy should have list of the exceptions.

Seems like more and more companies are adopting these plans. LOTS of loopholes. For instance, on our plan, one check up a year is covered, but IF your physician sends your blood work out, that is not included. You really need to read all the info on your plan.